No Harry, I'm not wrong. Your experience with this is anecdotal. I have, for nearly 30 years, served as chief of foot and ankle surgery at a major metropolitan hospital overseeing a large staff as well as practicing privately.
Your assumption that minimal incision surgery of the foot is analgous to minimially invasive endoscopic surgeries which have been employed by other specialties for such procedures as hernia repairs, gall bladder removals and knee surgeries is incorrect. Perhaps the only surery for the foot that is on par with those is the endoscopic plantar fascial release.
I've had too much experience over the years with performing revisional surgeries after practitioners who do only minimal incisional procedures botch the job. . . not necesarily because their techniques were flawed, but because they force an inadequate minimal procedure where an open procedure was necessary. I have no qualms with those fully qualified surgeons who carefully select those cases which can be appropriately treated with these techniques. But too many minimal incision practitioners who are not capable of the more complex procedures and thus employ the minimal incisional techniques whether indicated or not.
I am not suggesting that just because a surgeon recommends a more drastic procedure that he is always correct in doing so. But the discussion was aimed at a questioner who wanted to know if one or two bunionectomies should be done at one time and, clearly, that depends on the type of surgery that is contemplated as dictated by the nature of the deformity. I can assure you that if your own foot deformity actually called for an open procedure, it could not have been properly corrected by minimal incision surgery. So perhaps, your initial surgeon was more agressive than was necessary. But I can tell you that, without doubt, drawing on my long experience credentially, monitoring and auditing foot and ankle surgeons on my staff, as well as being intimately familiar with the capabilities of other surgeons in my area, more often than not, the minimal incision devotees are 90% practice management and 10% surgeons. Many have learned their craft at week-end seminars where cash flow and case presentation techniques are discussed as much or more than surgery. And more than a few have doubious professional credentials to boot. You should check with your foot surgeon to verify that if he/she is REALLY Board Certified . . That would mean Cerfification by The American Board of Podiatric Surgery not some "ambulatory" group.
I certainly would not dispute your pleasure with your treatment, but your one experience does not qualify you to state as you have done that, "It is not only too good to be true, it's the only way to do foot surgery." When correctly applied this sort of surgery can be useful, but, for the most part minimal incisional surgery of the foot is for minimal problems. |
